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Jeon W, Koh YK, Kang S, Kim H, Koh KN, Im HJ. Clinical characteristics and treatment outcomes of children and adolescents with aggressive mature B-cell lymphoma: a single-center analysis. Blood Res 2022; 57:41-50. [PMID: 35256548 PMCID: PMC8958376 DOI: 10.5045/br.2021.2021164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 12/08/2021] [Accepted: 12/24/2021] [Indexed: 11/26/2022] Open
Abstract
Background Aggressive mature B-cell non-Hodgkin lymphoma (B-NHL) is the most common non-Hodgkin lymphoma in children. The outcome of chemotherapy for B-NHL has improved over decades. Methods We reviewed 82 children and adolescents with B-NHL diagnosed at Asan Medical Center between 1993 and 2020. The D-COMP/COMP (daunomycin–cyclophosphamide, doxorubicin, vincristine, and prednisolone), Pediatric Oncology Group (POG)-9219/9315/9317, R-CHOP/CHOP (rituximab–cyclophosphamide, doxorubicin, vincristine, and prednisolone), and Lymphomes Malins B 89 (LMB89)/LMB96 regimens were administered. In 2018, rituximab was added to the LMB protocol (R-LMB) for advanced-staged Burkitt lymphoma (BL). The patients’ clinical features and treatment outcomes were retrospectively analyzed. Results The most common subtype was BL (61%), followed by diffuse large B-cell lymphoma (DLBCL) (35%). The median age was 7.8 (range, 1.3‒16.4) years, and the most frequently used regimen was French‒American‒British (FAB)/LMB96 (58 patients, 70.7%). The 5-year overall survival (OS) and event-free survival (EFS) rates were 92.5% and 85.7%, respectively. The EFS rates of patients with BL and DLBCL were 90.0% and 79.3%, respectively. Among the FAB/LMB risk groups, group C (85.7%) had a significantly lower 5-year OS (P=0.037). Eleven events occurred (6 relapses, 3 deaths, and 2 secondary malignancies) during the median follow-up of 7.1 (range, 3.7‒118.5) months. Two patients treated with R-LMB had good outcomes without complications. Conclusion Various treatment regimens have favorable outcomes in pediatric patients with B-NHL. However, further studies are needed to improve survival in high-risk patients. In addition, careful monitoring for acute toxicity or secondary malignancy due to intensive multidrug chemotherapy is required.
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Affiliation(s)
- Woojung Jeon
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Young Kwon Koh
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sunghan Kang
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hyery Kim
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung-Nam Koh
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ho Joon Im
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Choi HJ, Shin J, Kang S, Suh JK, Kim H, Koh KN, Im HJ. Long-term treatment outcomes of children and adolescents with lymphoblastic lymphoma treated with various regimens: a single-center analysis. Blood Res 2020; 55:262-274. [PMID: 33380561 PMCID: PMC7784128 DOI: 10.5045/br.2020.2020220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 11/02/2020] [Accepted: 11/12/2020] [Indexed: 12/03/2022] Open
Abstract
Background Lymphoblastic lymphoma (LBL) is the second most common subtype of pediatric non-Hodgkin lymphoma. Modified treatments derived from the LSA2-L2 regimen resulted in encouraging survival, but toxicities and long-term sequelae have been problematic. At present, the acute lymphoblastic leukemia (ALL)-type protocol has demonstrated efficacy in LBL. We analyzed the outcomes of children and adolescents with LBL treated with various regimens. Methods From 1991‒2018, this study enrolled 63 patients diagnosed with LBL at Asan Medical Center. Medical records were retrospectively analyzed. Results Among 63 patients, most patients (38.1%) presented with stage IV at diagnosis, and two had central nervous system (CNS) involvement. At a median follow-up of 160 months, the 5-year event free survival (EFS), overall survival (OS), and relapse free survival (RFS) were 68.8%, 79.3%, and 71.3%, respectively. Among 61 patients who received chemotherapy, 27 patients (44.3%) received the NY protocol, and 14 (23.0%) received the ALL-type protocol. There was no significant difference in 5-yr OS (85.2%/78.6%), EFS (73.5%/78.6%), and RFS (73.5%/78.6%) between the NY and ALL protocol groups, regardless of immunophenotype. Thirteen patients (21.3%) received prophylactic cranial radiotherapy with no difference in the incidence of CNS relapse based on irradiation. Conclusion This study showed no difference in outcome between the NY and ALL-type protocols, regardless of stage or immunophenotype. In addition to improving the effectiveness of treatment, it is necessary to continuously appraise the appropriate chemotherapy regimen, considering toxicities and long-term prognosis, for pediatric LBL.
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Affiliation(s)
- Ho Jung Choi
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Juhee Shin
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Sunghan Kang
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Jin Kyung Suh
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Hyery Kim
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Kyung-Nam Koh
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
| | - Ho Joon Im
- Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
- Division of Pediatric Hematology/Oncology, Department of Pediatrics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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Lee SS, Kim JM, Ko YH, Huh J, Kang CS, Kim CW, Kang YK, Go JH, Kim MK, Kim WS, Kim YJ, Kim HJ, Kim HK, Nam JH, Moon HB, Park CK, Park TI, Oh YH, Lee DW, Lee JS, Lee J, Lee H, Lim SC, Jang KY, Chang HK, Jeon YK, Jung HR, Cho MS, Cha HJ, Choi SJ, Han JH, Hong SH, Kim I. Korean Pediatric/Adolescent Lymphoma - Incidence and Pathologic Characteristics -. KOREAN JOURNAL OF PATHOLOGY 2010. [DOI: 10.4132/koreanjpathol.2010.44.2.117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Seung-Sook Lee
- Department of Pathology, Korea Cancer Center Hospital, Seoul, Korea
| | - Jin-Man Kim
- Department of Pathology, Chungnam National University, Daejeon, Korea
| | - Young-Hyeh Ko
- Department of Pathology, Samsung Medical Center, Seoul, Korea
| | - Jooryung Huh
- Department of Pathology, Ulsan University Asan Medical Center, Seoul, Korea
| | - Chang Suk Kang
- Department of Pathology, Catholic University of Korea, Seoul, Korea
| | - Chul Woo Kim
- Department of Pathology, Seoul National University, Seoul, Korea
| | - Yun Kyung Kang
- Department of Pathology, Seoul Paik Hospital, Seoul, Korea
| | - Jai Hyang Go
- Department of Pathology, Dankook University, Seoul, Korea
| | - Min Kyung Kim
- Department of Pathology, Kangbuk Samsung Hospital, Seoul, Korea
| | - Wan-Seop Kim
- Department of Pathology, Konkuk Univeristy, Seoul, Korea
| | - Yoon Jung Kim
- Department of Pathology, Seoul Veterans Hospital, Seoul, Korea
| | - Hyun-Jung Kim
- Department of Pathology, Sanggye Paik Hospital, Seoul, Korea
| | - Hee Kyung Kim
- Department of Pathology, Soonchunhyang University Bucheon Hospital, Bucheon, Korea
| | - Jong Hee Nam
- Department of Pathology, Chonnam National University, Gwangju, Korea
| | - Hyung Bae Moon
- Department of Pathology, Wonkwang University, Iksan, Korea
| | - Chan-Kum Park
- Department of Pathology, Hanyang University, Seoul, Korea
| | - Tae In Park
- Department of Pathology, Kyungpook National University, Daegu, Korea
| | - Young-Ha Oh
- Department of Pathology, Hanyang University Guri Hospital, Guri, Korea
| | - Dong Wha Lee
- Department of Pathology, Soonchunhyang University Hospital, Asan, Korea
| | - Jong Sil Lee
- Department of Pathology, Gyeongsang National University, Jinju, Korea
| | - Juhie Lee
- Department of Pathology, KyungHee University, Seoul, Korea
| | - Hyekyung Lee
- Department of Pathology, Eulji University Daejeon Hospital, Daejeon, Korea
| | - Sung-Chul Lim
- Department of Pathology, Chosun University, Gwangju, Korea
| | - Kyu Yun Jang
- Department of Pathology, Chonbuk National University, Jeonju, Korea
| | | | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University, Seoul, Korea
| | - Hye Ra Jung
- Department of Pathology, Keimyung University, Daegu, Korea
| | - Min-Sun Cho
- Department of Pathology, Ewha Womans University, Seoul, Korea
| | - Hee Jeong Cha
- Department of Pathology, Ulsan University, Ulsan, Korea
| | - Suk Jin Choi
- Department of Pathology, Inha University, Incheon, Korea
| | - Jae Ho Han
- Department of Pathology, Ajou University, Suwon, Korea
| | - Sook Hee Hong
- Department of Pathology, Dong-A University, Busan, Korea
| | - Insun Kim
- Department of Pathology, Korea University Medical College, Seoul, Korea
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